Estrogen plus progestin increased risk for stroke and probable dementia in postmenopausal women: COMMENTARY

Atkins, David
November 2003
ACP Journal Club;Nov/Dec2003, Vol. 139 Issue 3, p63
Academic Journal
Most observational studies have reported substantially lower risk for dementia among women who had used hormone replacement therapy (HRT). The expectations of a protective effect against dementia were based on a compelling combination of basic science and epidemiology. In animal studies, estrogen has favorable effects on neurotransmission, cell growth, and prevention of β-amyloid accumulation and oxidative damage. In some earlier short-term trials, estrogen alone improved some cognitive measures such as number recall, but benefits were not consistent across different measures and were largely confined to younger women with postmenopausal symptoms. HRT remains a suitable option for women with bothersome menopausal symptoms, but women should understand that there are some risks involved and should regularly reassess their need for treatment with their physician.


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